A study published in the journal Cureus has shown that iron deficiency anemia (IDA) may have an impact on diabetes management and glycemic control.¹ Diabetes patients with anemia had higher HbA1c levels, indicating poorer diabetes control.

In this cross-sectional study, the main objective was to examine the relationship between IDA, HbA1c levels and glycemic parameters in patients with diabetes, both type 1 and type 2. For this they enrolled 143 adult patients diagnosed with diabetes attending OPDs. Their mean age was 55 years and over half of the study group was male. Serum ferritin levels below 100 ng/mL, transferrin saturation below 20% and other hematologic parameters were used to define IDA. Additionally, a subgroup of patients underwent continuous glucose monitoring (CGM) to obtain daily glucose profiles and assess glycemic dynamics. The aim of the study was to determine how IDA may impact HbA1c levels and glycemic control in individuals with diabetes.

Nearly 80% had type 2 diabetes. The duration of diabetes ranged from less than 5 years in 43.4% of the participants, 5-10 years in ~33% and over 10 years in ~24%. None of the selected participants had any known hematological disorders other than IDA.

Results showed that the prevalence of iron deficiency anemia (IDA) among the diabetic cohort was 39.9%. The mean HbA1c levels were higher among the anemic diabetes patients compared to those who did not have IDA; 7.2% vs 6.8% suggesting a potential influence of IDA on HbA1c values. Moreover, CGM data showed that the patient with IDA spent more time in hyperglycemic ranges and exhibited greater glucose variability. Other parameters of iron deficiency including low ferritin levels and high red cell distribution width (RDW) were also found to have a correlation, albeit weakly positive, with HbA1c levels.

This study illustrates the high prevalence of IDA in patients with diabetes and may be linked to inaccurate HbA1c values and poor short-term glycemic control. The authors however caution that further larger controlled studies are needed to fully comprehend the mechanisms connecting IDA to changes in HbA1c levels and glycemic dynamics. By implementing optimized screening and treatment strategies for IDA, it is possible to enhance the accuracy of diabetes monitoring and potentially improve outcomes for patients.

Reference

1.   Eman Elsheikh, et al. Implications of iron deficiency anaemia on glycemic dynamics in diabetes mellitus: a critical risk factor in cardiovascular disease. Cureus. 2023 Nov 25;15(11):e49414. doi: 10.7759/cureus.49414.